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Hypoglycaemia and Hypoglycaemia Awareness
Published in Anthony N. Nicholson, The Neurosciences and the Practice of Aviation Medicine, 2017
Patients with Type 2 diabetes can experience hypoglycaemia whether treated with insulin or sulphonylureas, and severe and occasionally fatal outcomes have been recorded for both treatments. Reported rates of hypoglycaemia in clinical trials may underestimate hypoglycaemic risk. In the United Kingdom Prospective Diabetes Study (1998b), a trial of intensive therapy among patients with Type 2 diabetes, the proportion of patients suffering a major hypoglycaemic event per year was 0.4 per cent for those taking chlorpropamide, 0.6 per cent for glibenclamide and 2.3 per cent for insulin. Median HbA1c values were comparable with studies of intensive insulin therapy in Type 1 diabetes, suggesting that the risks of hypoglycaemia are less in those with Type 2 diabetes, but higher during insulin treatment. Population-based studies suggest severe hypoglycaemia may be more common. Akram et al. (2006) reported a frequency of 0.44 episodes each year, around a third of those reported for individuals with Type 1 diabetes, a rate confirmed in a British population (Donnelly et al., 2005). Since the prevalence of Type 2 diabetes is far greater, these data indicate that severe hypoglycaemia is the greater overall problem in individuals with Type 2 diabetes.
Drying induced polymorphic transformation of pharmaceutical ingredients: a critical review of recent progresses and challenges
Published in Drying Technology, 2022
Jayanta Chakraborty, Midhuna Subash, Bhaskar N. Thorat
There are many other equipment and processing conditions that may lead to polymorphism of a drug product out of which chlorpropamide offers an interesting case. Otsuka and Matsuda[42] have shown that the polymorphic transformation of chlorpropamide can occur upon the application of compressive load during the formation of tablets. The die was maintained at various temperatures during the application of pressure and they reported that the environmental temperature and the amount of compressive energy per unit mass of powder had a profound effect on the polymorphic transition. Based on the experimental data they proposed that polymorphic transition from form A to C (or vice-versa) occurs through an intermediate amorphous form.